Setting and participants 15 174 Olympic athletes from nine country groups (United States, Germany, Nordic countries, Russia, United Kingdom, France, Italy, Canada, and Australia and New Zealand) who won medals in the Olympic Games held in 1896-2010. Medallists were compared with matched cohorts in the general population (by country, age, sex, and year of birth).

Main outcome measures Relative conditional survival.

Results More medallists than matched controls in the general population were alive 30 years after winning (relative conditional survival 1.08, 95% confidence interval 1.07 to 1.10). Medallists lived an average of 2.8 years longer than controls. Medallists in eight of the nine country groups had a significant survival advantage compared with controls. Gold, silver, and bronze medallists each enjoyed similar sized survival advantages. Medallists in endurance sports and mixed sports had a larger survival advantage over controls at 30 years (1.13, 1.09 to 1.17; 1.11, 1.09 to 1.13) than that of medallists in power sports (1.05, 1.01 to 1.08).

Conclusions Olympic medallists live longer than the general population, irrespective of country, medal, or sport. This study was not designed to explain this effect, but possible explanations include genetic factors, physical activity, healthy lifestyle, and the wealth and status that come with international sporting glory.

Footnotes

We thank the OlyMADMen.

Contributors: PMC came up with the study idea; contributed to the study design, analyses, preparation, and design of exhibits; and cowrote the first draft of the manuscript with DMS. SJW and AH contributed to the study design, analyses, preparation of exhibits, and writing of methods and results. WJM and JH collected and assembled the study dataset, assisted in data interpretation, and contributed to the manuscript writing. DMS developed the study idea with PMC; contributed to the study design, data interpretation, and design of exhibits; conducted the literature review; and cowrote the first draft of the manuscript (with PMC).

Funding: None.

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Data sharing: Data for Olympians used to construct the study sample are available from Bill Mallon of the OlyMADMen (bill1729@gmail.com).